Regional and local studies suggest that the Tufted Puffin Fratercula cirrhata in North America is declining in portions of its range. However, whether the overall population is declining, or its range is contracting with little change to the overall population size, is unknown. To examine population trends throughout its North American range, we assembled 11 datasets that spanned 115 years (1905–2019) and included at-sea density and encounter estimates and at-colony burrow and bird counts. We assessed trends for the California Current, Gulf of Alaska, and Bering Sea/Aleutian Islands large marine ecosystems (LME). We found: (1) nearly uniform and long-term declines of Puffins breeding in the California Current ecosystem, with most ecosystem colonies surveyed, (2) declining trends at two large colonies and in one at-sea dataset in the Gulf of Alaska LME, with the fourth smaller colony exhibiting no significant trend, and (3) positive trends at four out of five colonies in the Bering Sea/Aleutian Islands ecosystem complex, with no detectable trend at the fifth very large colony. The general pattern of Tufted Puffin declines across the California Current and Gulf of Alaska LMEs may be attributable to a variety of factors, but additional study is needed to evaluate the relative influence of potential population drivers both independently and synergistically. Potential mechanisms driving population increases in the Bering Sea/Aleutian Islands ecosystem include reduced depredation and bycatch, intrinsic population growth, and immigration. We found strong evidence for declines in two of the three LMEs evaluated representing approximately three quarters of the species’ North American range. This region of decline includes the Gulf of Alaska LME, which contains a significant portion of the species’ estimated total North American population. Despite data limitations, our analysis coupled with more focused and local studies indicates that the Tufted Puffin is a species of conservation concern.